Identifying holder for surgical ligatures



Oct. 26, 1954 R. c. CREELMAN IDENTIF YING HOLDER FOR SURGICAL LIGATURESFiled Nov. 2, 1953 Summum v il EN V EN TOR. RA W40/VD C'. cesa/11AMPatented Oct. 26, 1954 UNITED STATES OFFICE IDENTIFYING HOLDER FORSURGICAL LIGATURESl 1D Claims.

This invention relates to a novel device useful in surgical operationsfor holding and identifying ligatures. The invention is hereinillustratively described by reference to its presently preferred form,as devised for certain specific types of surgical operations, althoughit will be appreciated by those skilled in the art that variousmodifications and changes therein may be made without departing from theessentials of the invention.

Various surgical operations require numerous ligations, including thevaginal hysterectomy, operations for the repair of tendons and others.Certain important ligaments cut in these operations must be ligatedduring the course of the operation so as to render them easilyaccessible and identifiable for the completion stages. The practice hasbeen to leave these ligatures relatively long. Each ligature wasseparately identined by fastening to it a particular type of surgicalclamp. The diiferent clamps were allowed to hang suspended of their ownweight over the perineum and thus maintain the various ligaturesslightly taut and outwardly accessible. While this technique wasbasically feasible, the inconvenience and delays encountered inuntangling and segregating each ligature from the others when theligatures and clamps fastened to them were frequently jumbled togetherwas a distinct disadvantage.

An object of the present invention is to facilitate the holding andidentifying of ligatures applied in surgical operations and therebyreduce operating time.

Another object is to provide an identifying ligature holder for thedescribed purposes affording a more positive and more reliable means ofidentifying particular ligatures and the ligaments or other body membersto which they are connected, thereby reducing the possibility of errorsin the reconstruction phases of an operation.

A related object is a ligature holder by which any desired number ofligatures may be held in an orderly arrangement minimizing theobstruction or hindrance to the activities of the surgeon, In otherwords, the improved ligature holder so arranges the ligatures that theydo not appreciably block access to the operating area.

With these and other objects in mind, the z novel ligature identifyingholder comprises in its preferred form an elongated base strip of rigidor semi-rigid material conformed or conformable to the body contouralong the side of the incision or other operating area. For purposes nof the vaginal hysterectomy and similar operations two such holderdevices are conveniently used, one extending transversely over andaround the inner side of each leg closely adjacent to the perineum, suchdevices being secured in place such as by towel clips clamping to theskin through holes in each end of the base strip. The coils of a helicalspring or equivalent holder means with plural gripping elements mountedon the base strip in series arrangement serve as clamps for individualligatures. Appropriate indicia marked on the base strip adjacent thespring at different locations along its length afford a means ofidentifying the various ligatures pressed into the coils of the springat such locations.

Adjustable means are also provided for placing the spring initiallyunder a certain amount of tension so as to create the desired clampingpressure on the ligatures pressed into the spaces between spring coils.By virtue of this tension adjusting arrangement the curvature of thebase strip hence of the spring is permitted to be varied in conformitywith the contour of different body contact areas to which the device isapplied, yet a suitable value of spring tension providing the desiredgripping pressure on ligatures may be established in all such instancesby a compensating adjustment of the tension control arrangement.

These and other features, objects and advantages of the inventionincluding certain details of the presently preferred form thereof willbecome more fully evident from the following description by reference tothe accompanying drawings.

Figure 1 is a plan view of the ligature identifying holder.

Figure 2 is a side view of the same.

Figure 3 is a simplified view illustrating application of the inventionin the performance of a surgical operation.

As shown in Figures 1 and 2, the base strip l0 of the illustratedligature identifying holder is formed of an elongated strip of sheetmetal which is sufficiently thin to be bent longitudinally to differentcurvatures and yet has a suflicient stiifness or rigidity to prevent itsbuckling under the tension force of the ligature holder spring to bedescribed. In a typical case this base strip may be approximately oneand one-half inches wide and about ten inches long. Apertures i2 areprovided in opposite ends of the strip lli for securing the same inplace around the inside portion of the patients leg, as will beexplained more fully in connection with Figure 3. A lug I6 is struck upfrom the body of the strip intermediate the ends thereof as an anchorfor one end of the elongated helical spring I8. The opposite end of thespring is secured to one end of a screw 20. This screw passes slidablythrough aligned apertures in two additional lugs 22 and 24, struck upfrom the body of the strip near one end thereof. These latter two lugsare spaced apart lengthwise of the strip and are aligned with the lug I6so that a nut 26 threaded on the screw 20 .may be received between thelugs 22 and 24. This nut provides a means for adjusting the tension inthe spring I6.

A series of ligature identifying indicia 28 such as letters of thealphabet or numerals (illustrated) is inscribed or printed on the basestrip I along the length of the holder spring I8. In the example thenumbers l through 9 are marked on the base strip at spaced locationsalong the length of the spring to identify a possible nine differentligatures held between spring coils at the respective locations of suchidentifying numbers. The maximum number of identifying indicia requiredfor different operations may, of course, vary. The spacings betweensuccessive indicia may also be varied as desired, although for mostpurposes a uniform spacing will be satisfactory. The spacing between anytwo successive indicia should not be too small, however, since it mightthen become awkward or difficult to press the corresponding ligaturesinto the spring coils for gripping purposes or to remove them laterwithout disturbing adjacent ligatures.

It will be evident that a helical spring mounted in the illustratedmanner serves as a very satisfactory and inexpensive means forreleasably holding a series of threads or strings (the ligatures)extending transversely to the length of the spring, since it is a verysimple matter to press these ligatures down into the spaces betweenadjacent spring coils at desired locations along the length of thespring. natural resilient gripping force which may be established at adesired value by adjustment of the take-up nut 26 and screw 25. Thespring coils are preferably slightly separated from each other byplacing the spring under tension so that the ligatures are easilyinserted into the coil spaces, and yet the tension should not beexcessive or it will be awkward to remove individual ligatures withoutdisturbing others during the reconstruction phases of the surgicaloperation. It will, of course, be evident that the curvature of the basestrip Il) assumed in order to conform to the portion of the patientsbody against which it is placed, will inuence the adjustment required ofthe spring. This is true since the spring itself assumes the curvatureof the base strip when installed. The spring is on the convex side ofthe curved base strip, and the sharper the curvature, the greater thetendency for the coils to be separated on the outer side of the springwhere they receive the ligatures. Such variations may readily bycompensated, however, by take-up or opposite adjustments of the nut 26and tensioning screw 2U, and in this manner achieve the desired grippingpressure of the spring coils on the ligatures inserted therebetween.

Figure 3 illustrates in simplified fashion application of one of theligature-identifying holder devices in conjuncton with a surgicaloperation such as the vaginal hysterectomy. It will be noted in thisgure that the base strip I0 has been placed against the inner. side of.the patients leg The spring provides a adjacent the perineum, and thatthe ends of the base strip are suitably anchored so that it will notslip out of place during the course of the operation. The lower end maybe anchored to the patients skin as by a towel clip T, to the operatingtable or to the folds of a sheet, for instance, whereas the opposite endmay also be anchored to the skin or to drapes placed over the patientsbody in a manner which will be readily apparent to those familiar withoperating procedures and facilities. Thus positioned, the novel deviceserves as a highly convenient means for holding the individual ligaturesLl, L2, L3, etc. in an orderly arrangement off to the side of theopertaing area O from which the ligatures extend. Moreover, theindividual ligatures placed in the coils of the spring by pressing theminwardly while extending laterally to the spring, until they are grippedbetween adjacent coils and thus held, are identified by the indicia onthe holder so that when the reconstruction phases of the operation arereached, the surgeon may know definitely without any confusion theligaments or other body members to which they are fastened. In thismanner the former jumble of various identifying clamps and ligatures towhich they were fastened is avoided and the possibility of errors inincorrectly associating a particular type of clamp with a particularligament is reduced.

It will be appreciated, of course, that a similar ligatures identifyingholder may be mounted on the other leg of the patient to receive stillother ligatures extending from the opposite side of the operating area,so that the ligatures will be held completely out of the surgeons way inperforming the operation most expeditiously.

It will also be appreciated that if properly held in place along theoperating area a flexible base strip that is, one of fabric, leather, orother similar material, may be used in lieu of the relatively stiifmetal base strip constituting the preferred and illustrated form. Thissubstitution is possible under proper mounting conditions since all thatis necessary for basic purposes is to secure the ends of the spring inthe desired positions with the spring placed under the requisite tensionand to provide ligature-identifying indicia at intervals along thelength of the spring in accordance with the preferred mode of practicingthe invention. Likewise, it will be apparent that other specific meansof holding individual ligatures in place releasably at spaced locationsalong the base strip may be substituted for the helical spring, butagain the illustrated form is the preferred arrangement.

In general, therefore, it will be seen that invention is not necessarilylimited to the illustrated details since preferences or the requirementsof different applications of the invention may vary and may be satisfiedby different specific types of construction wtihin the principles of theinvention.

I claim as my invention:

l. A ligature holder for surgical operations comprising an elongatedrelatively stiff base strip, anelongated helical spring, anchor elementscarried by said base strip at locations on one side thereof spaced apartalong the length of said base strip, opposite ends of said spring beingconnected to the respective anchor elements, and adjustable meansassociated with said spring for varying the tension thereof and therebyvarying the gripping pressure of adjacent coils of said spring onsurgicalzligatures inserted between said coils.

2. The ligature holder defined in claim 1, wherein the adjustable meanscomprises a screw connected to one end of the spring and passingslidably through an aperture in one of the anchor elements, and a nutinserted on said screw and adapted to bear against the side of saidanchor element opposite the spring.

3. A ligature holder for surgical operations comprising an elongatedbase strip of relatively stilf material having suiicient exure to permitcurving the base strip to conform to an area of a patients body adjacenta surgical operating area, an elongated helical spring, and anchorelements carried by said base strip at locations on one side thereofspaced apart along the length of said base strip, opposite ends of saidspring being connected to the respective anchor elements.

4.. The ligature holder dened in claim 3, and adjustable meansassociated with a spring and the anchor elements placing the springinitially under predetermined tension suitable to provide desiredpressure of adjacent coils of said spring on individual ligaturesinserted therebetween.

5, A ligature holder for surgical operations comprising an elongatedbase strip conformable to the contour of a patients body at a locationadjacent a surgical operating area thereon, means carried by said basestrip on one side thereof providing a series of ligature-grippingelements l0- cated in successive spaced positions along a portion of thelength of said base strip, and ligature identifying indicia marked onsaid base strip alongside said series of gripping elements to identifyindividual ligatures gripped by the respective gripping elements.

6. The ligature holder dened in claim 5, Wherein the gripping meanscomprises an elongated l6 helical spring successive adjacent coils ofwhich constitute the ligature gripping elements.

7. The ligature holder dened in claim 6, and adjustable means associatedwith the spring for varying the tension thereof in variously curvedshapes of the base strip for providing a desired gripping pressure ofthe coils of said spring on ligatures wedged therebetween.

8. A ligature holder for surgical operations comprising an elongatedbase strip of relatively stii sheet metal adapted for bending to thecurvature of a patients body at alocation thereon adjacent a surgicaloperating area, an elongated helical spring, anchor elements carried bysaid base strip at locations spaced apart along the length thereof,opposite ends of said spring being connected to the respective anchorelements, and adjustable means connected to one end of said spring andengaging one of said anchor elements for varying the tension in saidspring to establish a desired gripping pressure of adjacent spring coilson surgical ligatures inserted between such coils.

9. The ligature holder dened in claim 8, wherein the anchor elementscomprise lugs struck up from the body of said base strip and adapted forconnection to respectively opposite ends of the spring.

l0. A ligature holder for surgical operations comprising an elongatedbase strip conformable to the contour of a patients body at a locationadjacent a surgical operating area thereon, and means carried by saidbase strip on one side thereof providing a series of ligature-grippingelements located in successive spaced positions along a portion of thelength of said base strip.

No references cited.

